Published:10/01/2007

Family Bed Benefits: Expert advice from a holistic pediatrician

By Roy Steinbock

I’ve heard that sleeping with my baby is necessary for bonding and attachment. My mother told me that she saw a report in the news that this was dangerous. What’s true?

Historically, where children sleep has largely been dictated by the family’s cultural background. For example, cultures that seem to value group and family unity—such as Japanese and Italians—have traditionally encouraged babies to share their parents’ bed. Americans, who in general value individuality and autonomy, have moved babies to their own sleeping arrangements right away. There are both risk and benefits associated with co-sleeping.

Proponents of co-sleeping suggest that bed sharing encourages healthy emotional and physiologic attachment between the child and parents. They claim that babies fall asleep more easily and sleep for longer periods than non–bed sharing infants. In addition, co-sleeping may support an environment that promotes breast-feeding. Co-sleeping can also be an opportunity for closeness and bonding that working parents may desire. Some studies claim that due to more frequent waking of all participants in shared sleeping arrangements, there is actually a decrease in the risk for Sudden Infant Death Syndrome (SIDS).

Bed-sharing detractors also weigh in. For starters, some folks feel that bed sharing doesn’t allow children to develop sleep autonomy and self-soothing skills needed for mature development. The American Academy of Pediatrics and the Consumer Product Safety Commission caution that many adult beds may be potentially unsafe for infants and pose a real concern regarding SIDS and suffocation deaths. Soft bedding, pillows and blankets, parental cigarette smoking, alcohol or drug use, and head and footboards with large openings are all common hazards.

Unfortunately, the current data on co-sleeping is quite mixed. For starters little is actually known about what constitutes normal sleep for infants and children. Research is usually done in sleep labs and is limited due to its unnatural setting. In addition, subjective studies regarding the social and emotional effects of sleep are subject to strong reporting bias. A recent study that followed children over an 18-year period found no long-term benefit or harm from bed sharing when compared to non–bed sharing.

Like many issues, the question is simple, but the answer is complex and lies within each family. No single sleeping arrangement is best for everyone. Each person is an individual with different biological, psychological, spiritual, and social needs and perspectives. The real question, is what is best for you and your family? I encourage my patients to answer this simple set of questions that will hopefully help guide you as well.

1. Is my child healthy both physically and emotionally?
2. Is my child happy and secure?
3. Am I and the rest of my family healthy both physically and emotionally?
4. Am I and the rest of my family happy and secure?

If your child is sleeping well, but you find yourself struggling, then something needs to change. Too often I see parents ignoring their own needs in attempt to provide the best for their children. So the real challenge is to answer these questions honestly, truly exploring your current situation. In addition, because things are in a constant state of change, it is also imperative to keep asking these questions over and over again. It may be helpful to consider how long you plan on co-sleeping, and to formulate a plan on when and how to wean your family from this arrangement.

If you are planning on sharing your bed with a child younger than one year old, here are some suggestions to make it a safer environment. • Refrain from smoking cigarettes or going to bed intoxicated from drugs or alcohol.

• If you are worn down and exhausted you may reconsider sharing your bed to avoid accidental suffocation.
• Avoid soft mattresses, pillows, and bedding.
• Other hazards include headboards and footboards with opening that can entrap or suffocate a small child.
• Remove any strings or cords from the sleeping area. Make sure to place your baby on her back to sleep, and never cover her face with anything.

Roy Steinbock, MD, runs the Mindful Pediatrics practice in Boulder, Colorado.